Healthcare Provider Details

I. General information

NPI: 1710948112
Provider Name (Legal Business Name): FANPING WANG M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 07/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2241 WANKEL WAY STE C
OXNARD CA
93030-0190
US

IV. Provider business mailing address

2241 WANKEL WAY STE C
OXNARD CA
93030-0190
US

V. Phone/Fax

Practice location:
  • Phone: 805-983-0922
  • Fax: 805-983-1997
Mailing address:
  • Phone: 805-983-0922
  • Fax: 805-983-1997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA56286
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberA56286
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: